Integration Mechanisms towards Hard Tissue of Ca-Aluminate Based Biomaterials

Six mechanisms have been identified, which control how Ca-aluminate materials are integrated onto tissue; 1) Main reaction, the hydration step of CA, 2) Apatite formation in presence of phosphate ions in the biomaterial, 3) Apatite formation in the contact zone in presence of body liquid, 4) Transformation of hydrated Ca-aluminate into apatite and gibbsite, 5) Biological induced integration and ingrowth, i.e. bone formation at the contact zone, and 6) Mass increase reaction, especially important when un-hydrated CA is used as coatings or as augmentation pastes. These six mechanisms affect the integration differently depending on a) what type of tissue the biomaterial is in contact with, b) in what state (un-hydrated or hydrated) the CA is introduced, and c) what type of application is aimed at (cementation, dental fillings, endodontic fillings, sealants, coatings and augmentation products). Both a pure nanostructural mechanically controlled integration, and a chemically induced integration seem plausible.